When did the epidemic “end”? In the early days of 2020, we imagined that the novel coronavirus would end up completely gone. When this became impossible, we hoped instead to eradicate it: If enough people were vaccinated, herd immunity would largely stop the spread of the virus. When this too became impossible, we accepted that the virus would still circulate but imagined that it could become, optimistically, like one of the four coronaviruses that cause the common cold or, pessimistically, as something more severe, flu-like.
Instead, COVID has settled into something much worse than the flu. When President Joe Biden declared this week, “The pandemic is over. If you notice, no one is wearing masks,” the state was still registering more than 400 COVID deaths per day—More than three times the average number of people with the flu.
This shift in goal posts is, in part, an account of the biological reality of COVID. The virus that emerged from Wuhan, China, in 2019 was already well at spreading — including from asymptomatic people — and eradication may not stand a chance once COVID has spread internationally. “I don’t think this was ever feasible,” says Stephen Morse, an epidemiologist at Columbia. With time, it became clear that too Immunity to COVID Simply not durable enough To get rid of through herd immunity. The virus evolves very quickly, and our immunity to COVID infection wears off very quickly – as with other respiratory viruses – even as immunity to severe disease continues. (Older adults with weaker immune responses remain at greatest risk: 88 percent of Covid deaths so far in September in people over 65.) With the public tired of pandemic measures and the government’s reluctance to push them, it seems unlikely that the situation will improve any time soon. Trevor Bedford, a virologist at the Fred Hutchinson Cancer Center, estimates that COVID will continue to determine the death toll of 100,000 Americans annually in the near future. This is also nearly three times as much as in a typical flu year.
I keep coming back to the flu because, early 2021, with the excitement of the vaccine still fresh in the air, Many experts said My colleague Alexis Madrigal said a reasonable threshold for lifting COVID restrictions was 100 deaths a day, roughly on par with influenza. The thinking went so far that we tolerate the risk of catching the flu without major disruptions to our lives. Since then, widespread immunity, better treatments, and a less virulent variant of Omicron have increased the risk of contracting COVID-19 for individuals down to an influenza-like level. But among the entire population, COVID still kills more people than influenza, because it still makes more people sick.
Bedford told me he estimates that Omicron has infected 80 percent of Americans. Going forward, COVID may continue to infect 50 percent of the population each year, even without another leap in development similar to Omicron. In contrast, influenza infects an estimated 10 to 20 percent of Americans annually. These are estimates, because the lack of testing hampers accurate case counts for both diseases, but the higher number of COVID deaths is the result of higher transmission. Tens of thousands of recorded cases – likely hundreds of thousands of actual cases every day – also add to The long burden of COVID.
The challenge of reducing COVID transmission is becoming more and more evident over time. In early 2021, surprising vaccine efficacy data initially boosted optimism Vaccination can significantly reduce transmission of infection. The cases of penetration were Underestimated it as very rare. And they were – in the beginning. But immunity to infection Not durable against common respiratory viruses. Influenza, the four common coronaviruses, respiratory syncytial virus (RSV), and others all re-infect us over and over again. The same has been proven with COVID. “At first, we had to make that very clear. When I saw 95 percent against mild disease, with trials in December 2020, we should have said this was not going to last,” says Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. Even vaccinating the entire world will not eliminate the transmission of COVID.
This coronavirus has also proven to be a smarter opponent than expected. Despite the relatively slow rate of mutation at the start of the pandemic, they quickly evolved into variants that are more contagious in nature and better at evading immunity. With each major wave, “the virus becomes more transmissible,” says Ruth Caron, a vaccine researcher at Johns Hopkins University. Coronavirus cannot remain more transmissible forever, but it can continue to change Basically evading our immunity forever. Its rate of evolution is much higher than that of common cold coronaviruses. It’s higher than H3N2 influenza – the most disruptive and fastest-evolving influenza virus. Omicron, according to Bedford, is equivalent to Five years of H3N2 evolution, its subvariants still outnumber the usual rate of H3N2. We don’t know how often omicron-like events will occur. The rate of change of COVID may eventually slow when the virus is no longer new to humans, or it may surprise us again.
In the past, influenza epidemics “ended” after the virus swept through so much of the population that it could no longer cause huge waves. But the epidemic virus has not disappeared. It became the new seasonal influenza virus. The 1968 H3N2 pandemic, for example, H3N2 Influenza Classifier Which still makes people sick today. “I think it probably caused more morbidity and mortality in all those years since 1968,” Morse says. The pandemic is over, but the virus continues to kill people.
Ironically, H3N2 has all but disappeared during the coronavirus pandemic. Measures such as social distancing and concealment are administered Almost completely eliminates the flu. (It’s not completely gone, though, and it probably is Back in full force this winter.) The incidence of other respiratory viruses, such as RSV, has also decreased. Experts hope that this would show Americans a new naturalWe simply can’t stand the flu and other respiratory illnesses every winter. Instead, the country is heading towards a new normal where COVID is also something we tolerate every year.
At the same time President Biden said, “The pandemic is over,” he went on to say, “We still have a problem with COVID. We are still doing a lot of work on that.” You might see this as a contradiction, or you might see this as how we treat every other disease — an attempt to normalize COVID, if you will. The government does not treat influenza, cancer, heart disease, tuberculosis, hepatitis, etc. as national emergencies that disrupt daily life, even as work continues to prevent and treat them. The US strategy on the coronavirus certainly appears to be heading in that direction. Broad restrictions such as mask authorizations are out of the question. Interventions targeting people at high risk of serious illness exist, but they do not receive much attention. This fall’s COVID-Booster campaign has been discontinued. Treatments like bebtelovimab And the Evusheld stays on shelves Unpublished and unused.
At the same time, hundreds of Americans are still dying from COVID every day and will likely continue to die from COVID every day. The cumulative annual number of deaths of 100,000 per year would make COVID Among the top 10 causes of death, before any other infectious disease. When the first 100,000 Americans died of COVID, in the spring of 2020, newspapers Commemoration of the grim teacher. New York times Dedicate her entire front page To chronicle the lives lost due to COVID. It might have been hard to imagine that, in 2020, the United States would accept 100,000 people dying from COVID each year. Whether or not that means the pandemic is over, the second part of the president’s statement is hard to argue with: COVID is a problem and it will continue to be.
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